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Brian,
I’d like to address three areas that I believe are inaccurate or misunderstood in your opinion piece above:
• The data is old. The American Hospital Association pronounced this BEFORE the release of RAND 4.0. The most recent data, which RAND used to report state pricing means and individual hospital system prices, is from 2020 (a year and a half ago). These data show that Indiana has the 4th highest commercial hospital prices and the fourth lowest professional prices. This information is consistent with other high-quality studies. RAND collected claims for a three year period in order to gauge pricing trends and to report prices by service line.
• The method is flawed. No, the method of comparing hospitals relative to Medicare’s reimbursement is used in many high-quality research studies from prestigious institutions such as the US Congressional Budget Office, Harvard, Johns Hopkins and Brookings. What’s different about the RAND studies is that it is the only study we’ve found that NAMES INDIVIDUAL HOSPITALS, providing an easily-understood, one-number comparison of their relative prices. This stings because it is effective, not because it is deficient.
• The Forum was better when it pursued these issues collaboratively seeking market solutions. Yes, it is true that the Forum sought for many years to address the issue of Indiana’s extremely high hospital prices collaboratively and with market-based approaches. The problem is – this didn’t work. The hospitals consolidated rapidly and erected contractual roadblocks in their payor contracts that prevented even modest market-based initiatives.
No one likes price caps or legislative interventions but, when markets are obviously and seriously compromised, something must be done.
Dave Kelleher